Treatment Burden in Myasthenia Gravis

Corticosteroids remain fundamental in myasthenia gravis management despite significant treatment burden profiles that create long-term health risks and quality-of-life impacts. Although prednisone provides rapid, effective symptom control and remains readily accessible without prior authorization requirements, chronic use generates substantial adverse effects ranging from immediate complications such as gastritis and insomnia to serious long-term consequences including osteoporosis, diabetes, hypertension, and weight gain. These adverse effects particularly impact patients with existing comorbidities, potentially exacerbating conditions such as cardiovascular disease and metabolic disorders.

Treatment expectations and standards have evolved significantly over decades, progressing from basic functional improvement goals to current emphasis on minimal symptom expression with Class 1 adverse event profiles. Modern treatment objectives include achieving MG-ADL scores of 0 to 1 while maintaining acceptable adverse effect burdens and incorporating durability of response as a critical factor. Patients and providers now seek interventions requiring less frequent dosing to reduce treatment complexity, improve adherence, and minimize health care system burden through fewer monitoring visits and dosage adjustments.

The clinical management burden extends beyond medication adverse effects to encompass frequent patient communications, dosage modifications, and crisis prevention strategies. Health care providers report substantial time investments in phone consultations and message management as patients navigate symptom fluctuations and medication adjustments. The shortage of neurologists compounds these challenges, making durable treatment responses increasingly valuable for both patient outcomes and health care resource utilization. Future therapeutic development focuses on achieving sustained disease control with reduced dosing frequency and improved safety profiles to address these multifaceted treatment burden issues.